National Provider Identifier [NPI]: |
1336313519 |
Last Name Of The Provider |
EVERTON |
First Name Of The Provider |
KATHRYN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1304 FAWCETT AVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984021911 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
82 |
Number Of Services |
2855 |
Number Of Medicare Beneficiaries |
1493 |
Total Submitted Charge Amount |
557604.5 |
Total Medicare Allowed Amount |
178113.74 |
Total Medicare Payment Amount |
148973.41 |
Total Medicare Standardized Payment Amount |
147681.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
112 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
1152 |
Total Drug Medicare AllowedAmount |
237.28 |
Total Drug Medicare PaymentAmount |
175.55 |
Total Drug Medicare Standardized Payment Amount |
175.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
2743 |
Number Of Medicare Beneficiaries With Medical Services |
1493 |
Total Medical Submitted Charge Amount |
556452.5 |
Total Medical Medicare Allowed Amount |
177876.46 |
Total Medical Medicare Payment Amount |
148797.86 |
Total Medical Medicare Standardized Payment Amount |
147505.5 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
186 |
Number Of Beneficiaries Age 65 to 74 |
702 |
Number Of Beneficiaries Age 75 to 84 |
469 |
Number Of Beneficiaries Age Greater 84 |
136 |
Number Of Female Beneficiaries |
1329 |
Number Of Male Beneficiaries |
164 |
Number Of Non Hispanic White Beneficiaries |
1206 |
Number Of Black or African American Beneficiaries |
108 |
Number Of AsianPacific Islander Beneficiaries |
83 |
Number Of Hispanic Beneficiaries |
43 |
Number Of American Indian Alaska Native Beneficiaries |
23 |
Number Of Beneficiaries With Race Not Else where Classified |
30 |
Number Of Beneficiaries With Medicare Only Entitlement |
1227 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
266 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1086 |